Ear diseases: Common ear diseases & rare ear diseases

Wiebke Richter
Ohrenkrankheiten: Häufige Ohrenkrankheiten & seltene Ohrenerkrankungen

Ear diseases: Common ear diseases & rare ear diseases

The human ear is a sensitive and at the same time one of the most important sensory organs, which is not only associated with hearing, but also with balance. If the ear becomes diseased, this can therefore lead to major restrictions in everyday life and have serious consequences. For example, chronic ear diseases are often a reason for persistent hearing loss. However, not all symptoms that affect hearing and balance are necessarily an indication of an ear disease. They are often caused by other illnesses. Below you can find out which common and rare ear diseases there are and which symptoms are often misunderstood as such.

Ear disease - the most common conditions

Ear infections

Inflammation is one of the most common ear diseases. These are infections of the ear, which are named according to the area they affect.

Symptoms: earache, feeling of pressure, impaired hearing, feeling sick, sometimes headache, dizziness, fever, redness/swelling behind the ear.

Causes: The infections are caused by viruses or bacteria that enter the ear from outside or through the nasopharynx.

Diagnosis: An ear infection can be diagnosed with the help of an otoscopy and, if necessary, a hearing test.

Possible consequences: Severe cases can lead to hearing loss or tinnitus.

Treatment: Bacterial infections can usually be treated well with antibiotics, but symptoms are initially relieved with painkillers and nasal spray.

Forms:

Cholesteatoma

Cholesteatoma is a purulent inflammation of the middle ear that is chronic. The disease is triggered by ingrowths from the external auditory canal.

Symptoms: Discharge (foul-smelling), ear pressure, increasing hearing loss, earache, headache.

Causes: Can be congenital or occur as a result of an eardrum defect or chronic middle ear inflammation.

Diagnosis: An ear microscopy, a CT scan and a hearing test provide information about the presence of a cholesteatoma.

Possible consequences: A cholesteatoma can damage other areas of the ear and, in the later stages, may cause eye twitching, dizziness and facial paralysis.

Treatment: In order to completely heal a cholesteatoma, it is necessary to surgically remove the areas of inflammation. The removed areas are reconstructed using plastic surgery.

Otosclerosis

Otosclerosis refers to a pathological hardening and new bone formation on the ossicles.

Symptoms: Increasing hearing loss in one ear (usually in low frequencies), later both ears are affected. This is accompanied by tinnitus and dizziness.

Causes: The causes are not fully understood. Viral infections, faulty autoimmune processes, hereditary factors and hormonal changes are suspected.

Diagnosis: Is carried out with the help of hearing tests, including CT and X-rays if necessary.

Possible consequences: The sound is no longer transmitted sufficiently, which can result in hearing loss. Tinnitus is also partly caused by otosclerosis. In the absence of treatment, complete deafness can occur.

Treatment: Surgery can often improve hearing, and the symptoms of hearing loss are treated with hearing aids.

Rare ear disease

Ménière's disease

Ménière's disease is a rare disease of the inner ear. The increased pressure in the organ of equilibrium associated with it triggers dizziness, hearing loss and tinnitus.

Symptoms: attacks of dizziness, nausea, sweating, unilateral hearing loss, deep tinnitus, feeling of pressure on the ear.

Causes: It is not fully understood what triggers the condition. The fluid pressure in the vestibular apparatus, i.e. the organ of balance, is probably too high in Meniere's disease because too much perilymph is produced.

Diagnosis: To diagnose Meniere's disease, the symptoms and other causes of dizziness and ringing in the ears are clarified. This is followed by examinations of hearing and balance - audiometry (tests the function of the inner ear), a glycerol test (clarifies whether there is additional fluid in the inner ear) and a nystagmogram (recording of eye movements during seizures).

Possible consequences: The vertigo disorder can lead to permanent hearing loss, in some cases even to deafness. In addition, vertigo increases the risk of falling, which in turn can lead to injuries.

Treatment: The condition can be treated with medication. Various medications are used for acute attacks or accompanying symptoms such as nausea. A change in diet can also be helpful. If necessary, psychotherapy can help with coping with the condition. In more severe cases, injections or surgical procedures are considered.

Usher syndrome

The Usher syndrome is a group of diseases that are hereditary. It is characterized by a combination of hearing and visual impairment.

Symptoms: How exactly Usher syndrome manifests itself and how it progresses depends on the type of disease. Typical symptoms include early hearing loss or deafness from birth, as well as increasing blindness. The gradual blindness often initially occurs as night blindness. It is only later that color vision and visual acuity are also impaired.

USH1: Deafness from birth, balance disorder, retinal dystrophy beginning in childhood

USH2: Hearing loss (constant), retinal dystrophy beginning in puberty

USH3: Hearing loss (increasing), retinal dystrophy progressing from middle adulthood

Causes: Usher syndrome is inherited in an autosomal recessive manner. This means that the gene can be inherited if both parents carry it. The disease does not break out in the gene carriers, only when it is passed on does it break out in 25 % of cases. Different types are triggered depending on the gene affected.

Diagnosis: If visual problems are detected - including night blindness, difficulties with visual acuity and color recognition, problems getting used to changing light conditions, sensitivity to light - a visit to the ophthalmologist is recommended. Here, other diseases are ruled out and ophthalmologic examinations are carried out. Other specialists can be consulted if necessary. Molecular genetic diagnostics are also carried out.

Possible consequences: Progressive damage to hearing and vision as well as associated restrictions in everyday life and psychological stress.

Treatment: There is no treatment yet. Hearing aids, cochlear implants and visual aids are used to compensate for the symptoms. Therapeutically, the only aim is to slow down the disease with the help of medication.

Are tinnitus and sudden hearing loss ear diseases?

The assumption that tinnitus and dropsy are ear diseases is widespread. In fact, there is often a connection between the two diseases. However, they are not a disease in their own right, merely a symptom. Nevertheless, the signs should be taken seriously and, if in doubt, presented to an ear, nose and throat specialist.

Tinnitus can be caused by illnesses such as middle ear infections. However, it is usually the result of stress and excessive noise. Stress is also a risk factor for sudden hearing loss, which can be accompanied by tinnitus. However, inflammation and diseases of the ear are also factors in the occurrence of sudden hearing loss. Accordingly, both tinnitus and sudden hearing loss can be seen as signs of an ear disease, but are not recognized as such in themselves.

Is hearing loss an ear disease?

Hearing loss is not considered an ear disease, but it can occur as a result of one. Infections, noise exposure, age-related degeneration - hearing loss has many influencing factors. This makes it all the more important to have your hearing checked at an early stage if you suspect hearing loss. As shown above, numerous ear diseases can result in hearing loss. Consequently, signs of ear diseases should also be treated seriously and with the necessary caution.

Other symptoms and impairments of the ear

Tympanic membrane injuries

Tears and injuries to the eardrum can be caused by:

In mild cases, the tears heal on their own; larger tears usually require surgery.

Tympanic effusion

There is a kind of cavity behind the eardrum in the middle ear in which negative pressure can develop. Normally, this pressure can be easily equalized by swallowing. However, as a result of colds, secretions can accumulate, causing a feeling of pressure and sometimes hearing loss. The secretions also allow viruses and bacteria to enter the ear, potentially causing middle ear infections. Children are particularly frequently affected by tympanic effusion.

If the fluid does not drain away on its own within a few days, the ear, nose and throat specialist should be consulted and treatment sought. In severe cases, treatment involves minor surgery, but inhalation, steam baths, nasal rinsing and heat treatments usually provide relief.

Positional vertigo

In positional vertigo, so-called otoliths - small ear stones - enter the semicircular canals. The consequence is a sometimes severe feeling of dizziness with jerky movements of the body and head. Specific movement sequences, also known as positioning maneuvers, are used for treatment to remove the stones from the semicircular canals.

Barotrauma

Pressure changes in the middle ear, for example when diving or flying, can lead to barotrauma. This manifests itself as severe ear pain, dizziness, nausea and, in the worst case, ruptured eardrums or bleeding in the middle ear. The trauma can be treated with cortisone and, if necessary, surgery. In some cases, barotrauma results in hearing loss, which is treated with hearing aids.